MEDICARE: DR. FIRHANA ZAHID KHAIRULLAH DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	20A9087	CA

General Provider Information

NPI Number	:	1558438382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FIRHANA ZAHID KHAIRULLAH DO

Provider Business Mailing Address
First Line	:	3431 ROCKROSE DR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92882-2308
Country	:	US
Telephone Number	:	909-510-1412
Fax Number	:

Provider Business Practice Location Address
First Line	:	8686 HAVEN AVE
Second Line	:	STE 200
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-9109
Country	:	US
Telephone Number	:	909-706-3950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	11/22/2021

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